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High blood cholesterol was recognized as a major risk factor in the development of heart disease in the 1960s. Since then, doctors have recommended that adults undergo cholesterol testing as part of a comprehensive examination, in order to determine their risk of developing coronary artery disease. Cholesterol testing is done with a blood test. A little preparation is needed before having the test performed, but the requirements are not very strict.

Cholesterol and Disease

The presence of high blood cholesterol has long been considered a risk factor for the development of coronary artery disease, in combination with other genetic, health and lifestyle factors. The correlation between high blood cholesterol and coronary artery disease was first examined in the mid-20th century. The Framingham Heart Study, a study of a large group of people in Framingham, Massachusetts, has studied risk factors for coronary artery disease since the 1940s. One of the study's first discoveries was that high cholesterol increases the risk of coronary artery disease. Since then, cholesterol testing has been recommended for all adults.

Test Types

Cholesterol can be examined by a single test, which determines total blood cholesterol, or as part of a "lipid profile," a group of tests that looks at total cholesterol, subtypes of cholesterol and fats in the blood. Sometimes the single total cholesterol test is used as a screening tool. If the cholesterol level in the blood is found to be high, then additional testing, such as a lipid profile, is performed.


The test is performed by removing a small sample of blood from a vein, usually in the inner part of the arm. The blood is collected in a test tube and sent to a lab for analysis. Through a series of chemical processes, the total amount of cholesterol in the blood is determined. If testing for the subtypes of cholesterol -- high density lipoprotein and low density lipoprotein -- and fats is required, the same sample of blood can be used to conduct these analyses.

Test preparation

If total cholesterol is to be tested, no special preparation is required. Lipid profile testing, however, may require a nine- to 12-hour fast. Whether you fast or not, there is no restriction on consuming water before a test. Other types of beverages, however, can affect test results and should be avoided.


The National Cholesterol Education Program recommends that all adults age 20 and older be screened for high cholesterol at least once every five years. Specific recommendations about which type of test to perform, and how often, vary for different groups of people. A physician, after taking a medical history and performing an exam, may recommend more frequent or more thorough testing for some groups of people based on their health history.

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